Decision Date: 08/31/95 Archive Date:
08/31/95
DOCKET NO. 92-24 544 ) DATE
)
)
On appeal from the
Department of Veterans Affairs Regional Office in Nashville,
Tennessee
THE ISSUE
Entitlement to service connection for a disorder of the left
hand, wrist, and forearm, secondary to a service-connected
amputation of the right hand.
REPRESENTATION
Appellant represented by: Keith D. Snyder, Attorney
ATTORNEY FOR THE BOARD
L. L. Gann, Associate Counsel
INTRODUCTION
The veteran had active service from January 1966 to June
1969.
This appeal arises from a May 1992 rating decision of the
New York, New York, Regional Office (RO), which denied the
veteran's claim for service connection for a left hand,
wrist and forearm disorder, secondary to the service-
connected loss of his right hand. The veteran subsequently
relocated to Tennessee, and the Nashville, Tennessee, RO is
now handling this claim. In September 1993, the Board of
Veterans' Appeals (Board) denied entitlement to the
veteran's claim. On appeal, however, the U.S. Court of
Veterans Appeals (Court) vacated the Board's decision and
remanded for compliance with the instructions, [citation redacted].
The claims folder was returned
to the Board in May 1995, and docketed in June 1995.
Upon review, it is our opinion that the record is not yet
ready for consideration of entitlement to the benefits
sought on appeal.
REMAND
The veteran contends that he incurred a disorder of the left
hand, wrist, and forearm as a result of his service-
connected loss of his right hand. He asserts that while
washing dishes in 1988, he dropped a dish, which shattered.
Pieces of glass scattered, striking his left wrist and hand,
ultimately damaging nerve tissue which subsequently required
surgery. He generally avers that he dropped the dish
because the loss of his right hand prevented him from
holding onto the dish.
In January 1992, a Department of Veterans Affairs (VA)
examiner opined that the veteran suffers from median nerve
neuropathy with carpal tunnel syndrome of the left wrist
"due to a non-service-connected injury," an opinion relied
upon by the Board in its September 1993 decision denying
entitlement to service connection for a left
wrist/hand/forearm condition. The Court held, however, that
The report is devoid of any indication that the doctor
considered whether the absence of the right hand could have
caused the injury; in fact, it is evident from the report
that the sole purpose of his examination was to determine
the severity of the damage to the appellant's left wrist and
forearm. The other medical evidence that has been submitted
also lacks any opinions regarding whether the left wrist
injury was "proximately due to or the result of" the
service-connected amputation of the appellant's right hand.
Based upon the Court's statements, we conclude that the
veteran should be afforded another examination to determine
not only the severity of the veteran's left wrist and
forearm condition, but also the etiology of this condition,
and its possible relationship to the veteran's service-
connected amputation of the right hand.
The Court also found that the record has been inadequately
developed with regard to the details surrounding the 1988
accident which allegedly resulted in the veteran's current
left wrist and forearm disorder. We must, therefore, obtain
more detailed information from the veteran concerning this
incident.
The veteran argued before the Court that the VA should have
attempted to acquire treatment records from the Symms-Murphy
Clinic in Memphis, Tennessee, a private facility which had
provided treatment to the veteran after his initial injury.
The Court, however, disagreed finding that the veteran had
neither requested the VA to obtain such records, nor
authorized the release of records from this clinic. In a
letter to the Board dated in August 1995, his representative
indicated that the veteran is in the process of preparing
such a release for submission to the RO. If such a release
is received, the RO should contact the Symms-Murphy Clinic
to obtain copies of these records.
Finally, the Court noted that the veteran's claim that he is
not able to work as a result of his service-connected right
hand amputation and its residuals sufficiently raises the
issue of entitlement to a total rating based upon his
individual unemployability. See 38 C.F.R. § 3.321, 3.340,
3.341, 4.16 (1994). The RO must, therefore, undertake
appropriate development and adjudication of this claim.
In light of the foregoing, this case is REMANDED for the
following, but not necessarily in the order listed:
1. The RO should contact the veteran and request that he
submit a specific statement providing specific details of
the dishwashing accident in 1988 which led to his current
left hand/forearm/wrist disability. He should also be
requested to provide additional evidence, including medical
records, names and addresses of treating facilities, or lay
statements, in support of his claim, if he so desires.
Furthermore, should the veteran submit an appropriate
release, the RO should contact the Symms-Murphy Clinic in
Memphis, Tennessee, to obtain copies of all treatment
records for the veteran. All evidence obtained should
thereafter be associated with the claims folder.
2. The RO should arrange for the veteran to be examined by
a specialist in neurology to determine the status of the
veteran's left wrist, forearm, and hand condition. The
physician should discuss both the current severity of the
veteran's condition, as well as the etiology of all
diagnosed disorders. The examiner should also specifically
discuss the relationship of the veteran's left
wrist/forearm/hand condition to the service-connected
amputation of the right hand. The evidentiary basis and
medical rationale for all opinions expressed should be
provided.
A copy of this Remand and the claims folder should be made
available for review by the examiner prior to his or her
examination of the veteran.
3. The claim for a total rating for compensation as the
result of unemployability secondary to a service connected
disability should be developed.
4. The RO should review the instructions contained in this
Remand, to verify that all appropriate development has been
accomplished. Thereafter, the issue of entitlement to
service connection for a left hand/arm disorder, secondary
to the veteran's service-connected amputation of the right
hand, and the issue of a total rating based on
unemployability should be adjudicated.
If any aspect of the decision remains adverse to the
veteran, he and his representative should be furnished with
an appropriate Supplemental Statement of the Case, and
provided a reasonable opportunity for reply. The claims
folder should thereafter be returned to the Board for
appropriate adjudication of all issues fully developed for
appeal.
The purpose of this remand is to comply with our duty to
assist the veteran in the development of his well-grounded
claim. The Board intimates no opinion as to the ultimate
outcome of the veteran's claims.
JACK W. BLASINGAME
Member, Board of Veterans' Appeals
The Board of Veterans' Appeals Administrative Procedures
Improvement Act, Pub. L. No. 103-271, § 6, 108 Stat. 740,
___ (1994), permits a proceeding instituted before the Board
to be assigned to an individual member of the Board for a
determination. This proceeding has been assigned to an
individual member of the Board.
(CONTINUED ON NEXT PAGE)
Under 38 U.S.C.A. § 7252 (West 1991), only a decision of the
Board of Veterans' Appeals is appealable to the United
States Court of Veterans Appeals. This remand is in the
nature of a preliminary order and does not constitute a
decision of the Board on the merits of your appeal. 38
C.F.R. § 20.1100(b) (1994).
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